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Rectocele repair undone in 6 months!

I can't believe I'm writing this, but after having LAVH, BSO, A & P repair-rectocele repair- 6 months ago on 7/7/06, I am back in agony again. The surgery was done due to prolapse of a posterior uterus and a large rectocele.
I have done everything I was supposed to post-op, and even restricted my activity more than I had to and continued on the stool softener, but my colon is once again residing in my vagina. I've had pain since the surgery that never totally remiited.
Mesh was not used for the repair. The only "out of the ordinary" thing about my colon was the gastro. Dr. said on my pre-op colonoscopy that it was very "rigid". Maybe being "rigid" helped it force its way back through the vaginal walls???
I don't know now if it is still a gyno. issue, or if I should seek out a colo-rectal surgeon, or if both are needed.
I fear more "tests" to diagnose the problem, and I'm still down 25 pounds of the 35 I lost the last time this happened. I don't eat because I don't want to have to deal with large BM's that won't come out!
Please, if anyone can shed some light or hope on this issue; I'm so discouraged and in pain that I can barely function. Nothing has been normal for my husband and I since the whole problem started last May 2006. He has been AWESOME, but I know he has just about had it with a sick wife.HAS ANYONE USED A PESSARY FOR THIS? I have so little "sick leave" left on my job, that I would try anything to delay more surgery.Thanks for the input. I hope this message transmits, as several of my replys to other sisters never went through!

I don't have the answers for you but know I'm feeling your pain... I've just discovered that the pain/problems I've been having the past 6 months is a rectocele...still debating surgery. I'm a year + 4 months out from the TAH/BSO and just don't want to go through surgery/recovery again. I also have an awesome DH and he's been so supportive.
Will be following this thread to see what support other sisters bring. Hang in there.

I would think a pessary would help with the rectocele, be patient when trying them, I had to try 5 or 6 different kinds and didn't realize several times they weren't right or hurt until I left the office. Good Luck to you. Hugs.

Thank you for the kind words and encouragement. The "animations" helped generate a smile!
I have told those with the rectocele issue that mine was not the "routine" case; I don't want to scare everybody! A uterus prolapsing on the colon complicated the issue, and I really think the damage that was done is why I've had so much trouble.
I wish you only the BEST of outcomes, if you opt for surgery.
BL

Thank you for the input.
The difference now is that the colon is pushing more through the BACK wall of the vagina, and slightly through the floor. I can push them back into place-ugh!
At least until Monday I will hold onto your words that bring some "hope" for a non-surgical intervention with a pessary.
If you don't mind me asking, was yours used specifically for a rectocele or other organ prolapse?
BL

I had my TAH in May 2004. No prolapses was discovered at that time, but then again my hyst was a emergancy because I was terribly anemic and bleeding heavy. Five months post op I felt a bulge in there, so I saw my Gyn. He said it was a small rectocele and he thought doing kegels would help. Finally he sent me to a colon rectal dr. who ordered a defecogram. It showed a large rectocele and enterocele. MY gyn fixed it vaginally using pelvicol (pig material). He said it should last a life time. I felt the same symptoms within a few weeks of surgery. I knew something wasn't right. I had also developed stress incontinence. I went to a uro/gyn and he did a tvt and cystocele repair. He also did a lapro looking for cause of pelvic pain. He also checked for a rectocele. He found nothing. I knew this wasn't in my imagination. I had to have a spinal fusion surgery at 6 weeks post op. I had 2 herniated discs pinching nerves in both legs. Once recovered enough I went back to the colon dr. to see what was causing the bowel issues. She ordered another defecogram and sure enough there was that rectocele and enterocele I had suspected when I had my tvt done. I saw my Gyn for my yearly and he had a copy of my defeo test. When he did my internal he could not feel or see a rectocele. I went back to the uro/gyn. He also could not see or feel any prolapse. He said it was on film, so that was enough to warrant a repair. This time he went in abdominally and did a sacral colpopexy using pernament mesh. It was attached to the sacrum, then the mesh went under the vagina to lift it up off of the colon. The y part of the mesh was to support the posterior and anterior vagina. He only put it on the posterior floor because I had developed holes in my bladder when seperating the scar tissue. They had to do major bladder repairs. Within a few weeks I could feel the bm pushing up in my vagina again and I am having terrible bowel issues. I tols one of the dr's. he prescribed Estrace cream every other day. It has not helped as of yet. I had already been using it for a year without no good results. I saw one of the dr's Fri. because I have been going every other week, because my incision was open and still is not healed all of the way. He said not to worry that the vagina is supported enough that that nothing will fall out.(I had told him I felt like my bladder was dropping down) He also said for us to get my incision healed, then we will deal with the rectocele if I have one. I think it is because my vaginal tissue is so thin from being thrown into menopause from my TAH. (not enough estrogen)He told me it would be a simple repair if needed. I have no idea what I am going to do. I can't keep having surgeries. I use Miralax and stool softeners everyday.
I just wanted to tell you my experience. It has not been good. Alot of pain this last time. I had a grade 3 enterocele and rectocele and a vaginal vault prolapse.I also had to have a ovary removed due to a large cyst, then the bladder bivalve. I just want to be able to go regularly and like a normal person.
I hope you can find a solution to yours that will work out.
Peggy

Dear Peggy:
Thank you for sharing your experiences, but I am beyond words to express how sorry and horrified I am that anyone would have to go through everything you have experienced! Not to sound like a wimp, but I can't imagine tolerating everything you have endured. On top of the post-op discomfort, I have HUGE privacy issues when it comes to the diagnostic "tests" that go along with finding the problem, AND I don't have enough sick leave from work to cover me.
I have read about a defecogram, and cannot imagine having one when I have NEVER, and I do mean NEVER, used a public restroom for a bowel movement!
When I started down this road in May, 2006, I pre-warned my husband that most stories I had heard about "repair and reconstruction" of pelvic organs were not good. Every woman I had ever talked to, who had more than just the "basic" hysterectomy, ended up with multiple surgeries. Even a very good friend of mine, who was also a Nurse Practitioner in the field of female medicine, could not get by with just a single surgery-she needed 3, with 3 different surgeons!
I have family members who don't see what the big deal is, because "women have hysterectomies everyday!" and they all know women who recovered quickly and are totally "normal" now.
So along with the discomfort and fear of what's to come, I have the frustration of people doubting what I'm talking about!
In reading your account, I can already say that my Dr., when I told her about the "bulge" that sometimes comes through the back of my vagina, examined me and felt nothing. She said it was probably a full colon that would bulge, but everything is "still in place" and will stay there for "10 - 20 years". I am betting on sagging intestines, large and/or small, behind and maybe even on top of the vagina, similar to yours.
When my gastro. Dr. reported a "rigid and tortuous" (aka: stiff with lots of bends and twists) large intestine from my colonoscopy, I don't understand why someone didn't think about there being more to my colon issues than just the rectocele in the floor of my vagina. I can honestly say, I didn't know that the intestines could ever play such a role in the female pelvis!
My husband has been so tolerant. But another worry is that with all the issues "down there", sex is, needless to say, the last thing on my mind. But I don't know if he will be able to be "understanding" for as long as it may take, if ever, for me to feel "normal" again.
I'm sorry, I know I'm going on and on, but this website is my only place to vent. I don't want to wear out my husband, and there is no one else in my life right now that can relate.
Thank you, again, for your reply. I truly hope you will find answers and actions that will make you totally "WELL" again.
Sincerely, Pat (aka: Birdlover)

I guess the first thing you need to do is get a confirmation from the Dr to determine if this really is another rectocele. My suggestion is to return to the Dr who did the surgery. If it turns out that you do have another prolapse then it would be up to you to decide if you feel comfortable enough with your surgeon to have it done again or if you want to see someone else. My surgeries have been done by my Gyn and Uro/Gyn, I didn't see a colo-rectal specialist.
While waiting for my second prolapse repair I did use a pessary. It will help more with a cystocele than a rectocele but I did find improvement of symptoms with the pessary. It is an excellent non-invasive device to relieve some of the symptoms of pressure. If you decide to try a pessary, I wholeheartedly agree with Bowlinggrl, be patient and keep trying until you and your Dr find the right size and fit. You should not notice it's there if the fit is right.
Michelle

I guess the first thing you need to do is get a confirmation from the Dr to determine if this really is another rectocele. My suggestion is to return to the Dr who did the surgery. If it turns out that you do have another prolapse then it would be up to you to decide if you feel comfortable enough with your surgeon to have it done again or if you want to see someone else. My surgeries have been done by my Gyn and Uro/Gyn, I didn't see a colo-rectal specialist.
While waiting for my second prolapse repair I did use a pessary. It will help more with a cystocele than a rectocele but I did find improvement of symptoms with the pessary. It is an excellent non-invasive device to relieve some of the symptoms of pressure. If you decide to try a pessary, I wholeheartedly agree with Bowlinggrl, be patient and keep trying until you and your Dr find the right size and fit. You should not notice it's there if the fit is right.
Michelle

Dear Michelle,
Hi! Where have you been? I knew you had a repeat surgery in October, but I found no responses when I wrote to wish you well!
Now I see that you have had even MORE surgeries; please know that you are in my thoughts and prayers.
I really feel like a total "wimp" compared to you other sisters who have endured so much. I also feel like the medical world needs to draw attention to this area of female issues, because I am reading about too many unsuccessful surgeries that need to be done over, and over and over.................
As I said in one of my recent posts, I never knew anyone with successful "repairs" on the 1st try, and I STILL don't!
My problems started in May of 2006, and they are not over. You have been looking for relief since 2005! Please let me/us know if 2007 gets you into a state of stable/good health! Thank you for responding to another of my cries for help!
I hope this message transmits, as some of my others didn't seem to. Maybe I'm doing something wrong when I reply.
Sincerely,
Pat (aka Birdlover)

Pat,
I understand your wanting this fixed, I would take my time and have all the tests done, just remember that it takes 6-12 months to recover from surgery, so the longer you wait the better your tissues will have recovered. The way I got over my shyness is to close my eyes and remember that the doctors do their tests everyday and they won't remember that you are any different than anyone else. On the defogram, I found that to be not too bad, they had a screen around the 'toilet' for me to go in - I found it not nearly as bad as I had anticipated. Your rectocele symptoms sound the same as mine, my doctor called mine a total perineal collapse (the whole wall had collapsed). I'm hoping that my surgery holds and like you I am taking every precaution, time will tell. Good Luck to you, get a 2nd opinion from a uro/gyn and do your homework. My uro/gyn admitted that there is no perfect way to fix these problems, they all have their risks - somehow that didn't make me feel a lot better. Hugs.